Protect yourself from mosquitoes and Zika

The Pediatric Insider

© 2016 Roy Benaroch, MD

I remember a trip to the Florida Everglades in about 1978. Surrounded by mosquitoes, alligators, and miles of swamp, our teachers told us that every creature was a vital part of the food chain, and essential to the ecosystem.

I hate those bloodsuckers. The mosquitoes, I mean. Not the teachers.

Mosquitoes are more than an itchy nuisance. Though uncommon, serious diseases such as West Nile Encephalitis and dengue fever can be spread by mosquito bites in the USA. Our newest worry, Zika virus, is especially dangerous to pregnant women and their unborn babies. Though it’s not yet been spread by mosquitoes in the continental USA, Zika will be here soon. Itchy mosquito bites can be scratched open by children, leading to scabbing, scarring, and the skin infection impetigo. Prevention is the best strategy.

Try to keep your local mosquito population under control by making it more difficult for the insects to breed. Empty any containers of standing water, including tires, empty flowerpots, or birdbaths. Avoid allowing gutters or drainage pipes to hold water. Mosquitoes are “home-bodies”—they don’t typically wander far from their place of birth. So reducing the mosquito population in your own yard can really help.

Biting mosquitoes are most active at dusk, so that’s the most important time to be vigilant with your prevention techniques. Light colored clothing is less attractive to mosquitoes. Though kids won’t want to wear long pants in the summer, keep in mind that skin covered with clothing is protected from biting insects like mosquitoes and ticks. A T-shirt is better than a tank top, and a tank top is better than no shirt at all!

Use a good mosquito repellent. The best-studied and most commonly available active ingredient is DEET. This chemical has been used for decades as an insect repellant and is very safe. Though rare allergies are always possible with any product applied to the skin, almost all children do fine with DEET. Use a concentration of about 10%, which provides effective protection for about two hours. It should be reapplied after swimming. Children who have used DEET (or any other insect repellant) should take a bath or shower at the end of the day.

Other agents that are effective insect repellants are picaridin, oil of lemon eucalyptus, and IR3535 (also known as ethyl butylactylaminopropionate. Tasty!) These are probably not more effective than DEET, but some families prefer them because of their more pleasant smell and feel. Other products, including a variety of botanical ingredients, work for only a very short duration, or not at all. The CDC has extensive info on these products here.

There are also yard sprayers or misters, devices that widely spray repellants or pesticides. I couldn’t find much in the way to independent assessments of these products, but there’s no reason to think they wouldn’t work. Still, I’m leery about the idea of spraying chemicals all over the place, when we know that DEET sprayed on your child is effective and safe for both kid and environment.

About “Organic” or “Natural” insecticides or repellants – those are just  marketing words. In the world of chemistry, the word “organic” means that the molecule contains carbon. Organic compounds are no more or less likely to be dangerous to people or the environment than non-organic compounds; likewise, “natural” in no way implies that something is safe or effective (or even “natural” in the sense that most people mean that term.) These words are tossed around as part of the typical salad of meaningless marketing-speak on labels. Ignore them.

There are also devices that act as traps, using chemicals or gas to attract the mosquitoes from your yard. Although I don’t have much independent confirmation that these work, they are probably environmentally friendly and safe.

Some children do seem more attractive to others to mosquitoes, and some children seem to have more exaggerated local reactions with big itchy warm welts. To minimize the reaction to a mosquito bites, follow these steps:

  1. Give an oral antihisamine like Benadryl, Zyrtec, or Claritin (do NOT use topical Benadryl. It doesn’t work, and can lead to sensitization and bigger reactions.)
  2. Apply a topical steroid, like OTC hydrocortisone 1%. Your doctor can prescribe a stronger steroid if necessary.
  3. Apply ice or a cool wet washcloth.
  4. Reapply insect repellent so he doesn’t get bitten again.
  5. Have a Popsicle
  6. Repeat all summer!

Updated and adapted from a post in 2013

There you will learn from Yoda

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5 Comments on “Protect yourself from mosquitoes and Zika”

  1. Dee Says:

    Hello from Sri Lanka where dengue is such a menace 😦 The government does it best in educating the public and even handing our minor jail sentences for people who don’t take care of mossy breeding spaces in their homes/ gardens. I apply repellent on my 8mo old’s clothes and we use a net when she sleeps at night. Quite scary but we do what we can 🙂

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  2. Tom Brousseau Says:

    If Zika is from the planet Dagobah (as seen in picture), Yoda can protect you with the Force. Or, alternatively, you could get back in the partially submerged X-wing fighter and fly away 😏

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  3. Joy Says:

    Mosquitoes that spread Zika, the Aedes aegypti, bite mostly during the day. Also, using permethrin-treated items is a good way to protect yourself from a variety of biting things, including ticks.

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  4. Desiree Says:

    It’s here… we live in South Florida and Zika is officially here and spreading from Mosquitoes… thank you so much for the tips! A lot of moms stay away from DEET but from your info it appears there is no proven reason to?

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  5. Dr. Roy Says:

    Desiree, we knew it would happen. RE: DEET, nothing is more safe or more effective, so I’d use that — it’s been the gold-standard, most-studied repellent for decades. If you want to use something else, picaridin, oil of lemon eucalyptus, and IR-3553 all have good studies showing they work, too. But they’re newer and less-well established.

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